Cost-effectiveness of socioeconomic support as part of HIV care for the poor in an urban community-based antiretroviral program in Uganda.

Stella-Talisuna A, Bilcke J, Colebunders R, Beutels P Journal of Acquired Immune Deficiency Syndromes, 2014; Cost-effectiveness of socioeconomic support as part of HIV care for the poor in an urban community-based antiretroviral program

Socioeconomic support reduced nonretention in a community-based antiretroviral therapy (ART) program in Uganda. However, the resource implications of expanding socioeconomic support are large, and cost-effectiveness analysis can inform budget priorities.

This study compared the incremental benefits and costs of providing education, food, or both forms of support (dual support) with existing ART services from a health care provider's perspective.

Costs and outcome data were collected from a cohort of 2,371 adult patients with HIV receiving education, food, or dual support from Reach Out Mbuya between 2004 and 2010. The primary outcome was averted loss to follow-up.

After seven years:

  • 762 (33%) of the patients were loss to follow-up, while 42% were receiving food
  • in the context of providing ART, education support was less costly and more effective than the alternatives
  • the average unit cost for education, food and dual support were $237, $538 and $776, respectively
  • the average total annual costs were $88,643 for education, $538,005 for food and $103,045 for dual support

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